Association between endothelial dysfunction at birth and pediatric obesity

Obesity in pregnancy is associated with cardiovascular disease, metabolic syndrome, and obesity in offspring. Animal studies demonstrate endothelial dysfunction in offspring of obese mothers. Endocan is a biomarker for endothelial dysfunction. Our group previously found a positive association between maternal obesity and neonatal endocan levels at birth. Our objective is to assess whether endocan levels at birth are associated with pediatric obesity. From an existing prospective cohort study recruited July 2015 to April 2021, endocan level data were analyzed, in neonates < 33 weeks gestational age. Serum endocan levels were drawn within 48 hours of birth and weekly for 6 weeks. Pediatric weight data were collected from documented BMI between 24 and 37 months of age. Pediatric obesity was defined as BMI ≥95th percentile and overweight as BMI ≥85th percentile. Variables were compared with Student’s t test or Fisher’s Exact test as appropriate. Pediatric BMI data were available for 66 participants, including 4 obese children and 10 overweight children. The mean birth endocan level (ng/mL) in obese children and non-obese children were 573 and 321, respectively, (p = 0.005). Mean endocan level drawn at birth and weekly (up to 6 weeks) was significantly higher at 1 week of age in obese children (493 vs 281, p= 0.046), persisting at 6 weeks of age (613 vs 294, p = 0.043). There were no significant differences between gestational age at delivery, maternal obesity, maternal diabetes, chorioamnionitis or between overweight and non-overweight children. These data suggest obese children may have endothelial dysfunction present at birth. Epidemiologic and animal studies have demonstrated the important role intrauterine environment plays in neonatal body composition programming. Understanding the links between maternal obesity, neonatal endothelial dysfunction, and pediatric obesity may help reveal mechanisms of developmental origins of disease. If endocan is a reliable biomarker in neonates, it could be used to evaluate the efficacy of pregnancy interventions on offspring.View Large Image Figure ViewerDownload Hi-res image Download (PPT)